I will like to thank you in advance for giving us your advice. I started my med 2010 with the cd4 count of 226 using the combination of tenofovir, lamivadine and efavirenz and after 6month i went for cd4 test came back as 592 which i thought the combination is good. This year after one year without taking test to check, suprisely they swapped tenofovir for stavdudine. The old combination was good never experience any side effect beside dizzyness from efavirenz. My worry is the clinic never did any test before changing or say our government is not concern about us, secondly i am worried about the stavudine side effect as is seems more serious. just need to know more about how good or bad is my new combination and the side effect. Thank you.

Response from Dr. Henry

Tenofovir has fewer serious long term side effects than stavudine so if possible it is usually recommended to use tenofovir rather than stavudine. Many patients tolerate stavudine well but the concern is over the long term for risk for fat/metabolic problems and neuropathy. Stavudine is less expensive in many regions of the world so that is a factor favoring its use if resouces are limited. KH

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